title: Methylenedioxypyrovalerone ("bath salts"), related death: case report and review of the literature.
abstract: Cathinone derivatives (bath salts) have emerged as the latest drugs of abuse. 3,4-methylenedioxypyrovalerone (MDPV) is the primary active ingredient in bath salts used in this country. This article presents the second reported cause of death by MDPV intoxication alone. In April 2011, a delusional man was emergently brought to a hospital, where he self-reported bath salt usage. He became agitated, developed ventricular tachycardia, hyperthermia, and died. Comprehensive alcohol and drug testing was performed. Using the alkaline drug screen, heart blood contained 0.7 mg/L MDPV and peripheral blood contained 1.0 mg/L MDPV. His bizarre behavior with life-threatening hyperthermia was consistent with an MDPV-induced excited delirium state. MDPV is not yet found by routine immunoassay toxicology screens. Testing for MDPV should be considered in cases with a history of polysubstance abuse with stimulant type drugs, report of acute onset of psychogenic symptoms, excited delirium syndrome, or presentation in a hyperthermic state.
authors.affiliation: Maryland Office of the Chief Medical Examiner, 900 West Baltimore Street, Baltimore, MD, 21223.
authors.forename: Kilak
authors.initials: K
authors.lastname: Kesha
authors.forename: Cassie L
authors.initials: CL
authors.lastname: Boggs
authors.forename: Mary G
authors.initials: MG
authors.lastname: Ripple
authors.forename: Carol H
authors.initials: CH
authors.lastname: Allan
authors.forename: Barry
authors.initials: B
authors.lastname: Levine
authors.forename: Rebecca
authors.initials: R
authors.lastname: Jufer-Phipps
authors.forename: Suzanne
authors.initials: S
authors.lastname: Doyon
authors.forename: PaoLin
authors.initials: P
authors.lastname: Chi
authors.forename: David R
authors.initials: DR
authors.lastname: Fowler
mesh_terms: D000328:Adult; D052117:Benzodioxoles / Q000009:adverse effects* / Q000097:blood; D003693:Delirium / Q000139:chemically induced*; D015198:Designer Drugs / Q000009:adverse effects* / Q000032:analysis; D017809:Fatal Outcome; D005334:Fever / Q000139:chemically induced*; D053593:Forensic Toxicology; D006801:Humans; D008297:Male; D011619:Psychotropic Drugs / Q000009:adverse effects* / Q000097:blood; D011759:Pyrrolidines / Q000009:adverse effects* / Q000097:blood; D017180:Tachycardia, Ventricular / Q000139:chemically induced; D000094982:Synthetic Cathinone
chemical_list: D052117:Benzodioxoles; D015198:Designer Drugs; D011619:Psychotropic Drugs; D011759:Pyrrolidines; D000094982:Synthetic Cathinone
keywords: bath salts; designer drugs; forensic science; hyperthermia; methylenedioxypyrovalerone; recreational drugs; synthetic cathinones